Governmental Affairs Fellow
Freedom From Religion Foundation
The New Yorker has published an eye-opening piece about the tragic death of a young Hispanic woman in Texas — one of the first documented deaths attributable to the state’s abortion ban.
Yeniifer (Yeni) Alvarez, 27, a resident of Luling in central Texas, died in July 2022, during the 31st week of her high-risk pregnancy. Yeni’s official cause of death was reported as hypertensive cardiovascular disease associated with morbid obesity. The autopsy marked one contributing factor in Yeni’s death: pregnancy. As The New Yorker reports, the care offered to Yeni was routinely insufficient and incomplete, with no documentation in the extensive medical records that the option of a life-saving abortion was ever presented to Yeni.
Even before becoming pregnant, Yeni was a frequent patient in Luling’s emergency room with concerns about hypertension, high blood pressure, diabetes and obesity. During the Covid-19 pandemic, Yeni was hospitalized due to pulmonary edema, a life-threatening condition in which the lungs fill with fluid. All of this marked Yeni as a high-risk patient during her pregnancy.
A therapeutic abortion earlier in the pregnancy would have likely saved Yeni’s life, but it was seemingly never even discussed with Yeni, due to both the restrictive abortion landscape in Texas and the Catholic hospital network that treated Yeni.
The Catholic network that manages the hospitals closest to Yeni, Ascension Seton, says its mission is “rooted in the loving ministry of Jesus as healer.” In Luling, the only hospital, Ascension Seton Edgar B. Davis, is Catholic. Its labor-and-delivery unit closed years before Yeni’s death, there is no OB-GYN doctor onsite and the emergency room only has four beds and one physician overseeing the ER at a time.
Although undocumented pregnant women are eligible for limited government-funded health coverage and Yeni had applied during her pregnancy, she did not receive a response before her death. In Caldwell County, where Luling is located, more than 55 percent of the population is Hispanic or Latino, and more than a quarter of locals under 65 are uninsured. Medical problems are often left untreated until they become serious concerns, and when ill residents end up in the local ER, they are referred to distant facilities more equipped for their conditions. In Yeni’s case, she was referred to other Ascension Seton (Catholic) hospitals in the neighboring cities of Kyle and Austin. The stress of travel only made Yeni’s condition worsen.
Yeni’s health problems during pregnancy began when she was seven weeks pregnant and experienced a “threatened miscarriage” and alarming high blood pressure. Yeni’s doctor referred her to an OB-GYN at the Ascension Seton hospital in Kyle, about 25 miles away. Yeni declined admittance for her hypertension, due to financial concerns, including difficulty finding people to take her work shifts at a home-care job and needing the funds to cover car payments. Yeni’s physician emphasized the importance of taking her blood pressure medication, which Yeni couldn’t afford, and saw her five more times in the next couple of months, with no record that she ever discussed therapeutic termination.
At 22 weeks pregnant, Yeni woke up with a racing heart and dangerous shortness of breath, after weeks of on-and-off difficulty breathing. Yeni went to Luling’s ER to find that her blood pressure was once again at dangerous levels. Her doctor wanted to immediately transfer her to a better-equipped facility for high-risk pregnancies, but Yeni’s vitals needed to be stabilized first.
Yeni’s life was in danger from hypertension, and suspected preeclampsia. She was put in an ambulance headed to yet another Catholic hospital, Ascension Seton Medical Center in Austin.
There she was deemed a “high risk for clinical decompensation/death” and was immediately admitted to the intensive care unit and placed on assisted breathing. For the next four days, Yeni was treated by various doctors, including a specialist in maternal-fetal medicine, and her pulmonary edema and blood pressure improved. Yeni was discharged with medication, and, again, left the hospital with no conversation about her strained, vulnerable heart and lungs and the possibility of treatment by ending her pregnancy. No mention of the danger in continuing her pregnancy, namely the risks it could pose to her life, was ever given to Yeni.
Later the same month, Yeni again experienced continuous shortness of breath, but with mounting frustration of the treatment she was receiving and its financial burden, Yeni did not return to her OB-GYN.
At 31 weeks pregnant, Yeni again woke up with difficulty breathing and called 911. Paramedics put Yeni in an ambulance to be taken to Luling’s hospital so she could be transferred to Kyle via helicopter. But the ambulance was reportedly parked outside Yeni’s home for two hours. The paramedics were administering sedative medications to calm Yeni’s nerves, with the customary hypertension medicine being one of the very last medications given to her.
By the time the ambulance was en route to Luling’s hospital helipad, five minutes away from Yeni’s home, Yeni had no pulse. Luling’s ER doctor met the ambulance outside the ER and started trying to resuscitate Yeni, but turned to the baby when the routine emergency medicine four-minute mark passed. When Selene, Yeni’s baby named months beforehand, was delivered, she too was dead.
Yeni’s autopsy, naming hypertensive cardiovascular disease associated with morbid obesity as the cause of death, only listed pregnancy as a contributing factor, yet it was clearly the precipitating factor. Four medical experts told The New Yorker that Yeni’s death was preventable. All the experts agreed that an earlier abortion would have saved her life.
Yeni’s death took place only two weeks after the Supreme Court overturned Roe v. Wade. The landscape for abortion in Texas was already perilous well before the fall of Roe. In 2021, a state law, known as SB 8, effectively banned nearly all abortions after six weeks of pregnancy, with one vague exception for medical emergencies. The law infamously authorizes citizens to bring lawsuits against people, likely health care workers, who help with banned abortions and even incentivizes informers with a $10,000 reward. (Shortly after Yeni’s death, in August 2022, Texas lawmakers passed yet another law, this one outright banning abortion from “the moment of conception” and stipulating that physicians performing abortions could face life in prison plus a $100,000 civil fine for each unlawful abortion.)
Accessibility to adequate maternity care is a struggle in Texas, let alone the access to abortion, even in cases of medical emergencies. Many counties are not equipped to handle high-risk pregnancies, especially in rural areas such as Luling, and doctors have been leaving the state or retiring early to avoid the risk of being penalized for their treatment decisions.
Doctors in states banning abortion are, as a consequence of fear of prosecution, avoiding discussing medically necessary abortions with patients, even with critically ill patients such as Yeni. And this is causing women to die. Yeni should have been told the true danger she was in — and all of her available options. The Catholic hospital network treating Yeni continually — and knowingly — failed her when she was at her most vulnerable.
Ascension Seton is the second largest and wealthiest Catholic hospital network in the United States, running 140 hospitals in 19 states. The National Nurses United union recently released a report titled, “How Ascension Betrays its Mission by Gutting Care for Pregnant Patients and Babies.” The report goes into detail about how Ascension is closing obstetrics health care in low-income communities, eliminating care in predominantly Black and Latino neighborhoods and heightening the nationwide maternal death rate.
Medical neglect by Catholic hospitals is not confined to states with outright abortion bans. In another case involving a Catholic hospital in Ohio, Brittany Watts, a young Black woman, was criminally charged after suffering a miscarriage at 21 weeks and six days at home last September. She was arrested under an obscure Ohio law penalizing the treatment of a human corpse in a way that would “outrage . . . community standards,” a fifth-degree felony. The outrage was the way she was treated.
Watts was admitted to a Catholic hospital after severe vaginal bleeding. Her waters had broken and she had severely low amniotic fluid, which endangered her. Medical staff recommended inducing the nonviable fetus but spent eight hours deliberating whether it was legal to induce labor, even though under Ohio law at that time, abortion was legal through 22 to 24 weeks. Watts left without receiving appropriate care, then returned a day later only to leave again without receiving treatment, after waiting four more hours as staff deliberated. Watts returned to the hospital after she miscarried at home because of complications, including a retained placenta. That’s when the Catholic hospital that hadn’t given her appropriate treatment called the police, even though Watts miscarried at home, after being told the miscarriage was inevitable and that the fetus was too immature due to gestational age to survive outside the womb.
As Watts’ attorney Traci Timko put it, “Rather than focusing on healing physically and emotionally, she was arrested and charged with a felony and is fighting for her freedom and reputation.” Timko told CNN that Watts was “demonized for something that takes place in the privacy of [women’s] homes regularly.” The coroner’s report found the fetus had died in utero and had no signs of injury. Earlier this month, reason prevailed after a grand jury thankfully dismissed the criminal charges that should never have been filed. And, thankfully, Watts survived.
Both of these cases point to the dangerous landscape pregnant women are now facing around the nation, now not confined to Catholic hospitals but every OB-GYN practice and hospital in 21 states banning or severely restricting abortion care. You can now be criminalized for having a miscarriage, and you can now die without ever even discussing the life-saving option of abortion with the doctors entrusted with your care. Yeni’s avoidable death is quite certainly a grim portent of further such instances to come.